Provider Demographics
NPI:1043570542
Name:NKEMCHAP, ACHIANGA
Entity Type:Individual
Prefix:
First Name:ACHIANGA
Middle Name:
Last Name:NKEMCHAP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11613 CLOCKTOWER LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3514
Mailing Address - Country:US
Mailing Address - Phone:301-323-5151
Mailing Address - Fax:
Practice Address - Street 1:11613 CLOCKTOWER LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3514
Practice Address - Country:US
Practice Address - Phone:301-323-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide